Summary: 01/06/2011
REQUEST FOR GRADUATE PROGRAM EXTENSION
A student who is seeking an extension is to make the request through his/her supervisor. Students must be registered
in their program in order to request an extension. After reviewing all appropriate documentation, the FGSR will make
the final determination as to whether this request will be approved. Time extensions may be granted for one semester.
This request is to be made at least two months prior to the end of the semester.
Name: _______________________________________________ Student Number: __________________________
Legal Last Name Legal First Name
Current Address: _______________________________________________________________________________
Current E-mail Address: _________________________________________________________________________
Degree: ____________________________________ Major: _____________________________________________
Please provide sufficient evidence of progress to warrant an extension, as well as a statement of what remains to be
done, and the time-frame for its completion (Where appropriate, please attach additional documentation).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Student Signature: _________________________________________ Date: _______________________________
Approvals (Where appropriate, please attach additional documentation):
Supervisor's Comments: I support this request I do not support this request